• Title/Summary/Keyword: multiple admissions

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Classify the Acute Drug Intoxication Patients with Poisoning Severity Score(PSS) and Calculate the Optimal Cutoff Value of PSS, PSSsum to Predict Poor Prognosis (급성 약물 중독 환자에서 Poisoning Severity Score (PSS)를 이용한 중증도 분류와 중증도 분류에 있어 PSS 값과 PSSsum 값의 Optimal Cutoff Value)

  • Park, Hyun Woo;Park, Ha Young;Kim, Han Byeol;Park, Keon Woo;Lee, Sang Hun;Lee, Hyun Wook;Lee, Je Won;Hwang, Tae Sik
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.75-85
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    • 2018
  • Purpose: This study examined the Poisoning Severity Score (PSS) from acute poisoning patients, to determine the relationships among the PSS, PSSsum, the primary outcome (prolonged stay at the ER over 24 hours, general ward and ICU admission and the application of intubation and mechanical ventilator, and the administration of inotropes). Methods: A retrospective study was conducted through the EMR for 15 months. The PSS grade was classified according to the evidence of symptoms and signs. The differences in the primary outcomes between the PSS of when a single organ was damaged, and the PSS, PSSsum combined with the grade of when multiple organs were damaged, were studied. The cutoff value was calculated using the receiving operating characteristics (ROC) curve. Results: Of the 284 patients; 85 (29.9%) were men with a mean age of 48.8 years, and their average arrival time to the ER was $4.4{\pm}6.7\;hours$. The most frequently used drug was hypnotics. The number of patients with PSS grade 0, 1, 2, 3, and 4 was 17, 129, 122, 24, and one, respectively. No ICU admissions, application of intubation and mechanical ventilators, administration of inotropes were observed among the patients with PSS grades 0 and 1 but only on patients with PSS grades 2 to 4. At PSS, when separating the patients according to the number of damaged organs, 17 had no symptoms, 133 had one organ damaged, 75 had two organs damaged, 36 had three organs damaged, and 23 had four organs damaged. Significant differences were observed between increasing number of damaged organs and the primary outcome. Conclusion: Among the acute poisoning patients, the PSS was higher in severity when the grade was higher. The number of damaged organs and the primary outcome showed meaningful statistical differences. This study confirmed that when the patients' PSS>2 and PSSsum>5, the frequency of ICU admission was higher, and they were considered to be severe with an increased prescription risk of application of intubation and mechanical ventilator, and the administration of inotropes.

The SOFA Score to Evaluate Organ Failure and Prognosis in the Intensive Care Unit Patients (중환자실에 입원한 환자의 장기부전 및 예후 평가를 위한 SOFA 점수체계의 의의)

  • Kim, Su Ho;Lee, Myung Goo;Park, Sang Myeon;Park, Young Bum;Jang, Seung Hun;Kim, Cheol Hong;Jeon, Man Jo;Shin, Tae Rim;Eom, Kwang Seok;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Seung-Joon
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.329-335
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    • 2004
  • Background : The Sequential Organ Failure Assessment (SOFA) score can help to assess organ failure over time and is useful to evaluate morbidity. The aim of this study is to evaluate the performance of SOFA score as a descriptor of multiple organ failure in critically ill patients in a local unit hospital, and to compare with APACHE III scoring system. Methods : This study was carried out prospectively. A total of ninety one patients were included who admitted to the medical intensive care unit (ICU) in Chuncheon Sacred Heart Hospital from May 1 through June 30, 2000. We excluded patients with a length of stay in the ICU less than 2 days following scheduled procedure, admissions for ECG monitoring, other department and patients transferred to other hospital. The SOFA score and APACHE III score were calculated on admission and then consecutively every 24 hours until ICU discharge. Results : The ICU mortality rate was 20%. The non-survivors had a higher SOFA score within 24 hours after admission. The number of organ failure was associated with increased mortality. The evaluation of a subgroup of 74 patients who stayed in the ICU for at least 48 hours showed that survivors and non-survivors followed a different course. In this subgroup, the total SOFA score increased in 81% of the non-survivors but in only 21% of the survivors. Conversely, the total SOFA score decreased in 48% of the survivors compared with 6% of the non-survivors. The non-survivors also had a higher APACHE III score within 24 hours and there was a correlation between SOFA score and APACHE III score. Conclusion : The SOFA score is a simple, but effective method to assess organ failure and to predict mortality in critically ill patients. Regular and repeated scoring enables patient's condition and clinical course to be monitored and better understood. The SOFA score well correlates with APACHE III score.

The Compositions and the Characteristics of the Chinese National Test for University Admissions, and the Analysis on Items Concerning Chemistry (중국 대학입학시험의 구성 및 특징과 화학 문항 분석)

  • Kim, Hyun-Kyung
    • Journal of The Korean Association For Science Education
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    • v.31 no.8
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    • pp.1158-1174
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    • 2011
  • In this study, we examined the compositions, basic principles, and the area of the National Higher Education Entrance Examination (GaoKao) in 2009, we also analyzed the categories and characteristics of items. Also, the GaoKao was analyzed in terms of test specifications, the number of items, item patterns, difficulty levels, and implications of the College Scholastic Ability Test(CSAT) were explored. Results show Natural Science section of the National Test 1, 2 are 300 points per 150 min, and Natural Science, and Chemistry of Shanghai is 150 points each per 120 min. Also, the GaoKao contained multiple choice and fill in the blanks questions, and the description items are composed of experiments of various types. The GaoKao Natural Science section is composed of physics, chemistry, biology but not earth science, which is different from the CSAT. GaoKao requires basic understanding or the observation ability to reasoning, the complex thinking ability, especially emphasized on the experiment ability. The range of possible questions is in the examination outline, not the curriculum, and the ratio of questions from the University level is high. In the analysis of the behavioral domain, the ratios of the understanding and application items is higher than the CSAT, and inquiry items is lower, but the inquiry items are deeper. In case of the ratio of the expected correct answer, National Test 1 and National Test 2 is similar, but the difficult items or about 20~39% of the test is 4~5 times to that of the CSAT, making the GaoKao very difficult. The peculiar characteristics of GaoKao is the emphasis on the experiment, and even though the practical items is of lower ratio, they are very useful in life.